摘要
目的探讨儿童百日咳的临床特点。方法回顾性分析江西省儿童医院2017年1月至2020年1月收治的181例百日咳患儿的临床资料。按年龄分为≤3个月组(n=88)、>3个月组(n=93);按有无接种百白破疫苗(DTP)分为免疫组(n=23)、未免疫组(n=137),排除未接种完全16例,接种史不详5例;按有无混合其他病原菌感染分为无混合感染组(n=78)、混合感染组(n=103)。比较不同分组患儿的临床特点。结果≤3个月组痉挛性咳嗽、阵发性青紫、呼吸暂停、窒息、呼吸衰竭等临床症状发生率,并发重症肺炎、肺实变和(或)肺不张发生率,WBC计数及住院时间均显著高于>3个月组,差异有统计学意义(P<0.05)。阵发性青紫、呼吸暂停、呼吸衰竭、窒息、重症肺炎仅见于未免疫组,未免疫组重症肺炎、呼吸衰竭发生率,WBC计数及住院时间均显著高于免疫组,差异有统计学意义(P<0.05)。混合感染组肺实变和(或)肺不张发生率、WBC计数及住院时间均显著高于无混合感染组,差异有统计学意义(P<0.05)。结论≤3个月、未接种疫苗的百日咳患儿病情更重,住院时间更长;混合其他病原菌感染是影响百日咳患儿治疗效果的重要因素;WBC水平在一定程度上可提示患儿的预后。
Objective To investigate the clinical characteristics of pertussis in children.MethodsClinical data of 181 pertussis children admitted Jiangxi Children’s Hospital between January 2017 to January 2020 were retrospectively analyzed.According to the age,these children were divided into≤3 months old group(n=88)and>3 months old group(n=93).According to whether they had received diphtheria-tetanus-pertussis(DTP)vaccine,these children were divided into immunized group(n=23)and non-immunized group(n=137).Sixteen children with incomplete inoculation and 5 children with unknown inoculation history were excluded.According to whether they had mixed infection with other pathogens,these children were divided into non-mixed infection group(n=78)and mixed infection group(n=103).The clinical characteristics were compared between different groups.Results Compared with>3 months old group,the incidence of spasmodic cough,paroxysmal cyanosis,apnea,asphyxia,respiratory failure,severe pneumonia,pulmonary consolidation and/or atelectasis,red blood cell(WBC)count,and length of hospital stay increased in≤3 months old group(P<0.05).Compared with non-immunized group,the incidence of respiratory failure and severe pneumonia,WBC count,and length of hospital stay increased in immunized group(P<0.05).Paroxysmal cyanosis,apnea,respiratory failure,asphyxia and severe pneumonia were found only in non-immunized group.Compared with non-mixed infection group,the incidence of pulmonary consolidation and/or atelectasis,WBC count,and length of hospital stay increased in mixed infection group(P<0.05).Conclusion Children with pertussis who are≤3 months of age and have not received DTP vaccine are sicker and stay longer in hospital than children who are>3 months of age and have received DTP vaccine.Mixed infection with other pathogens is an important factor affecting the therapeutic efficacy for pertussis.In addition,WBC level can indicate the prognosis of pertussis children to some extent.
作者
何美娟
陈强
李岚
吴爱民
张帆
HE Mei-juan;CHEN Qiang;LI Lan;WU Ai-min;ZHANG Fan(Department of Respiratory Medicine,Jiangxi Children’s Hospital,Nanchang 330006,China)
出处
《实用临床医学（江西）》
CAS
2021年第1期30-32,38,共4页
Practical Clinical Medicine
关键词
儿童
百日咳
临床特点
免疫
临床分析
children
pertussis
clinical characteristics
immune
clinical analysis
